“Was?”

“The little girl—six years old—died. Five others have died, too, including the woman with the antibiotic-resistant strain, Marianna Barsotti.” He rubs his eyes. “And another child.”

“Oh, fuck,” Alana groans. Over the years, she has learned, out of necessity, to emotionally detach herself from the plight of victims. But it becomes almost impossible when children are involved. The prospect of having to watch helplessly as kids die here in Italy, like she did in Liberia, is beyond discouraging. “The death toll of this thing, Byron . . . we’re nearing critical mass.”

“There are going to be more deaths. A lot more. Our job now is to minimize them as best we can.”

“How do we do that?”

“Most of the other patients—even the ones in the ICU—improve on antibiotics. The biggest issue is how quickly people die from this plague. If we can keep them alive for twenty-four to forty-eight hours, the medicine seems to do the trick.”

“Not for Marianna Barsotti. And if her antibiotic-resistant version of the bug gets loose in the community . . .”

“We haven’t seen any other cases.”

“We will. There have got to be other options. Any progress on the vaccine?”

“Not really. Even if we can get enough of it here in time, there’s no evidence it will be effective for preventing the pneumonic plague.”

“What about using antiserum?” Alana asks, thinking of the technique of passively immunizing newly infected patients by infusing antibodies derived from the blood of recent plague survivors. “It’s pretty old school, but we tried it with Ebola to some success.”

“We’re working on that, too. We’ve harvested antibodies from Claudio Dora and a few other survivors. But it could take weeks, maybe months, to engineer enough antibodies to treat more than a handful of patients.”

“So we’re back to Epidemiology 101?”

“When all else fails . . .” he says quietly.

So far it all has. But she keeps the thought to herself.

“I want to show you something, Alana.” He pulls his chair around to her side of the table and extracts a thin laptop from his bag, opening it on the table in front of them. The screen fills with a detailed map of Genoa. “This is a time-synced map that charts the spread of the infection.” A red spot glows faintly in the northwest corner of the city. Byron taps it. “This is Zanetti’s construction site on what we’re calling ‘Day One’—the day Vittoria Fornero collapsed at the construction site. It’s possible—likely, even—Yasin Ahmed was sick before her, but since we don’t know for sure . . .” A central spot in the southeastern core of the city turns red. “This is the Ospedale San Martino. Day Three, when the second confirmed victim, Sonia Poletti, came down with the plague.” He taps a button and more red spots glow on the map, clustered mainly around the hospital. “This is the spread on Day Five. All of these cases, so far, can be traced back directly or indirectly to Vittoria.”